Increasing Diabetes Educators' Confidence in Physical Activity and Exercise Counselling: The Effectiveness of the “Physical Activity and Exercise Toolkit” Training Intervention

Shields, Christopher; Fowles, Jonathon R.; Dunbar, Peggy; Barron, Brittany; McQuaid, Stephanie; Dillman, Carrie

doi:10.1016/j.jcjd.2013.08.265

Cited by 21 publications

(12 citation statements)

References 18 publications

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“…These results are consistent with diabetes educators' low confidence in their patients to increase their PAE (Dillman et al 2010); however, this previous work also suggests that changing health care providers' perceptions of patients may influence their PAE practices. Providing workshop training increased diabetes educators' efficacy, perceived patient knowledge and improved diabetes educators' confidence in their patients to perform PAE (Shields et al 2013).…”

Section: Discussionmentioning

confidence: 99%

“…Sections of the questionnaire were based on previous work in the area; activity prescription questions were adapted from the national survey by Petrella et al (2007), confidence variables were incorporated because of the known impact on PAE counselling self-efficacy (Hébert et al 2012), and inclusion in other studies to evaluate physical activity prescription training (Dacey et al 2013). The questions regarding demographic information, current practice history, barriers, and postworkshop reflection were based on previous research in diabetes education (Dillman et al 2010;Shields et al 2013). …”

Section: Self-reflection Questionnairementioning

confidence: 99%

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Health care provider confidence and exercise prescription practices of Exercise is Medicine Canada workshop attendees

O’Brien

Shields

et al. 2017

Appl. Physiol. Nutr. Metab.

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Abstract:The Exercise is Medicine Canada (EIMC) initiative promotes physical activity counselling and exercise prescription within health care. The purpose of this study was to evaluate perceptions and practices around physical activity counselling and exercise prescription in health care professionals before and after EIMC training. Prior to and directly following EIMC workshops, 209 participants (physicians (n = 113); allied health professionals (AHPs) (n = 54), including primarily nurses (n = 36) and others; and exercise professionals (EPs) (n = 23), including kinesiologists (n = 16), physiotherapists (n = 5), and personal trainers (n = 2)) from 7 provinces completed self-reflection questionnaires. Compared with AHPs, physicians saw more patients (78% > 15 patients/day vs 93% < 15 patients/day; p < 0.001) and reported lower frequencies of exercise counselling during routine client encounters (48% vs 72% in most sessions; p < 0.001). EPs had higher confidence providing physical activity information (92 ± 11%) compared with both physicians (52 ± 25%; p < 0.001) and AHPs (56 ± 24%; p < 0.001). Physicians indicated that they experienced greater difficulty including physical activity and exercise counselling into sessions (2.74 ± 0.71, out of 5) compared with AHPs (2.17 ± 0.94; p = 0.001) and EPs (1.43 ± 0.66; p < 0.001). Physicians rated the most impactful barriers to exercise prescription as lack of patient interest (2.77 ± 0.85 out of 4), resources (2.65 ± 0.82 out of 4), and time (2.62 ± 0.71 out of 4). The majority of physicians (85%) provided a written prescription for exercise in <10% of appointments. Following the workshop, 87% of physician attendees proposed at least one change to practice; 47% intended on changing their practice by prescribing exercise routinely, and 33% planned on increasing physical activity and exercise counselling, measured through open-ended responses.Key words: Exercise is Medicine, physical inactivity, exercise prescription, primary care.

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Section: Discussionmentioning

confidence: 99%

Section: Self-reflection Questionnairementioning

confidence: 99%

Health care provider confidence and exercise prescription practices of Exercise is Medicine Canada workshop attendees

O’Brien

Shields

et al. 2017

Appl. Physiol. Nutr. Metab.

Self Cite

View full text Add to dashboard Cite

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“…Questions regarding demographic information, current practice history and barriers were based on published research in diabetes education. 19 , 20 Examples of how questions are worded are provided by O’Brien et al 6 …”

Section: Methodsmentioning

confidence: 99%

Exercise is medicine Canada workshop training improves physical activity practices of physicians across Canada, independent of initial confidence level

O’Brien¹,

Shields²,

Solmundson³

et al. 2020

Can. Med. Ed. J

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Background: Educational workshops help physicians (MDs) include physical activity and exercise (PAE) content in more patient appointments. It is unclear if MDs with varying degrees of self-confidence discussing PAE with their patients equally benefit from such training. We evaluated whether MDs’ initial self-confidence affects the impact of an educational PAE workshop. Methods: MDs (n = 63) across Canada completed self-reflection questionnaires initially and 3-months following a PAE workshop. MDs were divided into low-confidence [self-efficacy score (out of 100%): <40%; n = 21], medium-confidence (40-60%; n = 19) and high-confidence (>60%; n = 23). Results: PAE counselling self-efficacy increased in all groups (relative increase: Low=~40%, Medium=~20%, High=~10%). Training increased the low-confidence group’s knowledge, awareness of guidance/resources and perception of their patients’ interest in lifestyle management (~30% change; all p < 0.001). Compared to baseline, a greater proportion (all p < 0.001) of MDs reported prescribing exercise at 3-month follow-up in each of the low-confidence (10% to 62%) medium-confidence (16% to 89%) and high-confidence (57% to 87%) groups. Conclusion: PAE training favorably improved MDs’ self-confidence, perceived impact of many barriers and the proportion of MDs prescribing exercise, at each level of confidence. An educational workshop particularly assisted MDs with low-confidence (i.e., those who needed it the most) integrate PAE into their practice.

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“… 21 Questions regarding demographic information, current practice history and barriers were based on published research in diabetes education. 22 , 23 Previous training was assessed using a single item to select all the sources of education MDs may have received on PAE. Supporting factors (i.e., ‘facilitators’) that assist physical activity counselling and exercise prescriptions were included from a practical standpoint to describe what physicians are currently doing to incorporate PA into their practice.…”

Section: Methodsmentioning

confidence: 99%

The effects of previous educational training on physical activity counselling and exercise prescription practices among physicians across Nova Scotia: a cross-sectional study

et al. 2018

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Background: Physicians (MDs) report difficulty including physical activity (PA) and exercise (PAE) as part of routine care. MDs who report previous educational training in PAE may prescribe exercise more frequently. We evaluated the effects of previous training on perceptions and practices of PA counselling and exercise prescriptions among MDs in Nova Scotia.Methods: MDs (n=174) across Nova Scotia completed an online self-reflection survey regarding their current PAE practices. MDs who reported previous training (n=41) were compared to those who reported no training (n=133). Results: Trained-MDs were 22% more confident performing PA counselling than untrained-MDs (p<0.005). In patient appointments, trained-MDs included PAE more often (51% vs 39%; p=0.03) but trained-MDs and untrained-MDs had similar rates of exercise prescriptions (12%; p>0.05). The most impactful barriers (on a scale of 1 to 4) were lack of time (2.5) and perceived patient interest (2.4), which were unaffected by previous training (p>0.05).Conclusion: Previous training was associated with a higher confidence to include PAE discussions with patients by MDs in Nova Scotia, but had minimal influence on their many barriers that prevent exercise prescription. Although some training supports MDs inclusion of PAE into their practice, there is a need for greater, more intensive educational training to assist MDs in prescribing exercise.

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Increasing Diabetes Educators' Confidence in Physical Activity and Exercise Counselling: The Effectiveness of the “Physical Activity and Exercise Toolkit” Training Intervention

Cited by 21 publications

References 18 publications

Health care provider confidence and exercise prescription practices of Exercise is Medicine Canada workshop attendees

Health care provider confidence and exercise prescription practices of Exercise is Medicine Canada workshop attendees

Exercise is medicine Canada workshop training improves physical activity practices of physicians across Canada, independent of initial confidence level

The effects of previous educational training on physical activity counselling and exercise prescription practices among physicians across Nova Scotia: a cross-sectional study

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